Minority Based Community Clinical Oncology Program at Meharry Medical College

说明(申请人提供)：少数族裔人口在获得适当医疗保健方面存在多重障碍。这种差异在癌症方面尤其明显，因为非洲裔美国人的总体癌症死亡率高于所有其他种族。此外，男性和女性与癌症相关的黑人和白人死亡率的比率继续恶化。考虑到这些事实，显然需要为少数群体的癌症护理做出有意义的努力。这一努力的一个重点是有必要增加少数族裔和未得到充分服务的患者在癌症治疗(CT)和癌症预防和控制(CP/C)试验中的应计费用，在这些试验中，少数族裔人口的代表性严重不足，甚至校正了他们与高加索人口的相对频率。这项建议延续了Meharry医学院(MMC)的MBCCOP最初的成功成果，该计划建立并维持了一种机制，将最先进的癌症临床试验带给少数群体，并让社区执业医生参与NCI赞助的临床试验。这项申请将继续并加强具体目标，即1)通过将大量少数族裔患者纳入NCI批准的CT和CP/C研究来扩大癌症治疗的机会，2)让社区和社区卫生中心参与癌症试验，并调查它们对社区医疗实践的影响，3)增加社区执业医生对NCI批准的研究的参与，4)向照顾少数族裔和服务不足的人群的卫生保健提供者转让新技术。MMC有超过40%的新诊断癌症患者代表少数族裔，将成为其积极的癌症研究和治疗试验计划支持的中心核心。集水区将是大都会戴维森县(MDC)，那里的少数民族人口约占总人口的33%。MBCCOP的CT附属部分将继续包括最大的多医生肿瘤学实践(Sara Cannon研究所/田纳西肿瘤学)和MDC，Nashville Oncology Associates中唯一的少数族裔定向血液学/肿瘤学实践。这些团体共同照顾了大量少数族裔患者，并已被证明成功地将相当数量的患者安排在NCI批准的方案中。CP/C方案将继续使用已建立的初级保健保健诊所联盟，这些诊所侧重于少数族裔和服务不足的人，并将积累到具有CP/C组成部分的CT研究。社区卫生中心特别适合进行需要非癌症患者的CP/C研究，如乳腺癌预防试验。MBCCOP的总体设计及其已建立的基础设施、附属机构和明确定义的临床试验方法将继续吸引大量患者参加NCI批准的CT和CP/C研究。

DESCRIPTION (provided by applicant): Minority populations have multiple impediments to proper health care. This disparity is particularly noted for cancer where African-Americans have an overall cancer death rate that is greater than for all other ethnic groups. Furthermore, the ratio of black:white cancer related mortality continues to worsen for both males and females. Considering these facts, it is clear that meaningful efforts for cancer care is required for minority populations. One focus of this effort is the necessity to increase minority and underserved patient accrual to cancer therapy (CT) and cancer prevention and control (CP/C) trials where minority populations are substantially underrepresented, even correcting for their relative frequency to Caucasian populations. This proposal continues the successful initial accomplishments of the MBCCOP at Meharry Medical College (MMC) that established and sustained a mechanism to bring state-of-the-art cancer clinical trials to minority populations and to involve community practicing physicians in NCI-sponsored clinical trials. This application will continue and enhance the specific aims that are to 1) broaden access to cancer treatment by entering substantial numbers of minority patients onto NCI approved CT and CP/C studies, 2) involve communities and community health centers in cancer trials and investigate their impact on community medical practices, 3) increase community practicing physician participation on NCI approved studies and 4) transfer new technology to health care providers caring for minority and underserved populations. MMC, with greater than 40% of newly diagnosed cancer patients representing minorities, will serve as the central core supported by its active cancer research and treatment trials program. The catchment region will be Metropolitan Davidson County (MDC) where minority populations make up approximately 33% of the entire population. The CT affiliate components of the MBCCOP will continue to include the areas largest multi- physician oncology practice (Sara Cannon Research Institute/Tennessee Oncology) and the sole minority directed hematology/oncology practice in MDC, Nashville Oncology Associates. Together, these groups care for large numbers of minority patients and have proven successful in placing substantial numbers of patients on NCI approved protocols. The CP/C program will continue to use an established consortium of primary care health clinics that focus on minorities and the underserved as well as accruing to CT studies that have CP/C components. The community health centers are particularly well-suited to perform CP/C studies requiring non-cancer patients such as breast cancer prevention trials. The overall design of the MBCCOP with its established infrastructure together with affiliates and well-defined clinical trial methods will continue to accrue substantial numbers of patients onto NCI approved CT and CP/C studies.